糖耐量减低患者颈动脉内膜中层厚度与血小板活化的关系  

Relationship between Platelet Activation and Carotid Intima-media Thickness in Patients with Impaired Glucose Tolerance

作　　者：张栩[1] 赵家军[1] 于文[1] 

机构地区：[1]山东省立医院内分泌科,济南250021

出　　处：《中国临床医学》2005年第2期304-306,共3页Chinese Journal of Clinical Medicine

摘　　要：目的:观察糖耐量减低患者(IGT)血小板活化和颈动脉内膜中层厚度的变化,以探讨两者的相关性。方法:选择76 例IGT患者,测定其血小板α颗粒膜蛋白(GMP 140)的变化。同时应用高频超声测量颈动脉内膜中层厚度(IMT)。取35 例查体健康者为对照组,进行对比分析。比较IGT组患者IMT<0.9mm组和IMT≥0.9mm组患者血小板GMP 140 的变化,以及75g糖负荷后对血小板活化的影响。结果:IGT组血小板GMP 140 水平和IMT较正常对照组显著增加(P<0.01)。在IGT患者中,IMT≥0.9mm组较IMT<0.9mm组血小板GMP 140 升高更明显(P<0.01)。75 g糖负荷后可显著升高IGT组血小板GMP 140水平(P<0.01),且IMT≥0.9mm组升高更显著(P<0.01)。相关分析表明血小板GMP 140 与IMT之间显著正相关。多因素逐步线性回归分析表明,血小板GMP 140 是影响IMT的独立危险因素。结论:IGT患者存在血小板活化增强和颈动脉内膜中层厚度增加。糖负荷后可显著增加血小板活化程度。血小板活化是IMT增加的独立危险因素。Objective: To investigate the relationship between platelet activation and carotid intima -media thickness(IMT)in patients with impaired glucose tolerance (IGT).Methods: 76 patients with IGT were included and the level of platelet alpha granule membrane protein(Gmp-140)was measured in these patients. Meanwhile, IMT was observed with high resolution ultrasound. 35 healthy persons were enrolled as controls.Results: The levels of platelet GMP-140 and IMT were higher in the IGT group than those in the control group. Moreover, the level of platelet Gmp-140 in IGT patients with IMT≥ 0.9mm was significantly increased compared with that of IMT< 0.9mm group (P<0.01). Before and after oral 75g glucose loading for 2 hours, the changes of platelet Gmp-140 was higher in IMT≥ 0.9mm subgroup than that in IMT< 0.9mm subgroup. Linear correlation analysis showed that the level of platelet GMP-140 was significantly correlated with the level of IMT. Stepwise linear regression analysis showed that platelet GMP-140 was an independent risk factor to the increasing carotid IMT. Conclusion:Platelet activation as well as carotid IMT was significantly increased in the patients with IGT, and oral glucose loading aggravate the increasing platelet activation.The platelet activation is an independent risk factor which accelerate carotid atherosclerosis.

关 键 词：颈动脉内膜中层厚度 糖耐量减低患者 血小板GMP-140 独立危险因素 IGT患者 血小板活化程度 线性回归分析 IMT 颗粒膜蛋白 正常对照组 负荷后 血小板α 超声测量 对比分析 相关分析 相关性 健康者 升高 正相关 多因素 水平 

分 类 号：R587.2[医药卫生—内分泌] R587.1[医药卫生—内科学]